Direct Observations of Ordered Nanoporosity in Deprotonated 2-(Acetoacetoxy)ethyl Methacrylate (AAEMA-) Polymer: Preliminary Results.

Polymers based on 2-(acetoacetoxy)ethyl methacrylate, charged with iron or sodium, were thermally heated at 150 °C. Both polymers were studied and characterized by SEM, TEM, STEM microscopy and SAEDF techniques. The morphological investigation revealed that, upon heating, both polymers were endowed with microholes, sometimes perfectly ordered, whose dimensions varied from 4-5 nm to approximately 500 nm. In the case of an Fe-containing copolymer, unexpectedly, iron did not fill in the cavities, thus implying that it was "dispersed" in the polymeric matrix. Electronic microdiffraction documented that both polymers exhibited a proto-crystallinity, likely induced by thermal heating.

Occupational risk of nano-biomaterials: Assessment of nano-enabled magnetite contrast agent using the BIORIMA Decision Support System.

The assessment of the safety of nano-biomedical products for patients is an essential prerequisite for their market authorization. However, it is also required to ensure the safety of the workers who may be unintentionally exposed to the nano-biomaterials (NBMs) in these medical applications during their synthesis, formulation into products and end-of-life processing and also of the medical professionals (e.g., nurses, doctors, dentists) using the products for treating patients. There is only a handful of workplace risk assessments focussing on NBMs used in medical applications. Our goal is to contribute to increasing the knowledge in this area by assessing the occupational risks of magnetite (Fe3O4) nanoparticles coated with PLGA-b-PEG-COOH used as contrast agent in magnetic resonance imaging (MRI) by applying the software-based Decision Support System (DSS) which was developed in the EU H2020 project BIORIMA. The occupational risk assessment was performed according to regulatory requirements and using state-of-the-art models for hazard and exposure assessment, which are part of the DSS. Exposure scenarios for each life cycle stage were developed using data from literature, inputs from partnering industries and results of a questionnaire distributed to healthcare professionals, i.e., physicians, nurses, technicians working with contrast agents for MRI. Exposure concentrations were obtained either from predictive exposure models or monitoring campaigns designed specifically for this study. Derived No-Effect Levels (DNELs) were calculated by means of the APROBA tool starting from in vivo hazard data from literature. The exposure estimates/measurements and the DNELs were used to perform probabilistic risk characterisation for the formulated exposure scenarios, including uncertainty analysis. The obtained results revealed negligible risks for workers along the life cycle of magnetite NBMs used as contrast agent for the diagnosis of tumour cells in all exposure scenarios except in one when risk is considered acceptable after the adoption of specific risk management measures. The study also demonstrated the added value of using the BIORIMA DSS for quantification and communication of occupational risks of nano-biomedical applications and the associated uncertainties.

Shifts in bentonite bacterial community and mineralogy in response to uranium and glycerol-2-phosphate exposure.

The multi-barrier deep geological repository system is currently considered as one of the safest option for the disposal of high-level radioactive wastes. Indigenous microorganisms of bentonites may affect the structure and stability of these clays through Fe-containing minerals biotransformation and radionuclides mobilization. The present work aimed to investigate the behavior of bentonite and its bacterial community in the case of a uranium leakage from the waste containers. Hence, bentonite microcosms were amended with uranyl nitrate (U) and glycerol-2-phosphate (G2P) and incubated aerobically for 6 months. Next generation 16S rRNA gene sequencing revealed that the bacterial populations of all treated microcosms were dominated by Actinobacteria and Proteobacteria, accounting for >50% of the community. Additionally, G2P and nitrate had a remarkable effect on the bacterial diversity of bentonites by the enrichment of bacteria involved in the nitrogen and carbon biogeochemical cycles (e.g. Azotobacter). A significant presence of sulfate-reducing bacteria such as Desulfonauticus and Desulfomicrobium were detected in the U-treated microcosms. The actinobacteria Amycolatopsis was enriched in G2P­uranium amended bentonites. High-Angle Annular Dark-Field Scanning Transmission Electron Microscopy analyses showed the capacity of Amycolatopsis and a bentonite consortium formed by Bradyrhizobium-Rhizobium and Pseudomonas to precipitate U as U phosphate mineral phases, probably due to the phosphatase activity. The different amendments did not affect the mineralogy of the bentonite pointing to a high structural stability. These results would help to predict the impact of microbial processes on the biogeochemical cycles of elements (N and U) within the bentonite barrier under repository relevant conditions and to determine the changes in the microbial community induced by a uranium release.

A DFT study of the adsorption of glycine in the interlayer space of montmorillonite.

The adsorption properties of clay minerals have been widely studied in several technological areas, due to their versatility, absorption capacity and catalytic properties. The interaction of amino acids with clay surfaces can be interesting due to their role in prebiotic scenarios. Different degrees of hydration and the adsorption of the glycine molecule and glycinium cation in the interlayer space of montmorillonite were investigated by means of calculations based on density functional theory (DFT). Our calculations show that the cation exchange of K+ by glycinium in the interlayer of hydrated K-montmorillonite is highly possible and exothermic. This supports previous experimental results by explaining the possible adsorption of glycine as a molecule and cation. Glycine is adsorbed in a zwitterionic form in the interlayer without being solvated with water. Besides, glycine and glycinium are highly exothermically adsorbed in the interlayer. The interlayer spacings under different conditions were in agreement with the experimental values. Hydrogen bonds and electrostatic interactions between molecules and surface atoms are responsible for this exothermicity. The IR spectra were calculated and compared with the experimental results showing interesting frequency shifts depending on the intermolecular interactions in the interlayer space of montmorillonite.

Uso y abuso de opioides en el área norte de la provincia de Cádiz / Use and abuse of opioids analgesics in the northern area of the Cádiz province

Introducción: La utilización de opioides en dolor crónico no oncológico (DCNO) es controvertida porque no está demostrada su utilidad a largo plazo. Hay pocos estudios sobre dependencia y adicción; del mismo modo se ha descrito un aumento de mortalidad en pacientes que reciben altas dosis de opioides en DCNO. Por esto, nos propusimos analizar a los pacientes que superaban la dosis diaria definida, DDD, en el área norte de la provincia de Cádiz. La DDD es la dosis diaria de mantenimiento media en adultos. Material y métodos: El área norte de la provincia de Cádiz tiene una población aproximada de 420.000 habitantes. Se detectaron a los pacientes que superaban la DDD de opiáceos en diciembre de 2014. Estudiamos la historia clínica de todos estos pacientes. Resultados: Se encontraron 23 pacientes que, por lo menos, duplicaban la DDD del opiáceo utilizado. Por tanto, la incidencia en nuestra área era de un paciente por cada 18.000 habitantes. Cuatro de ellos son pacientes oncológicos (17 %), el resto de dolor crónico no oncológico (83 %). Predomina claramente el dolor tipo osteo-articular (65 %), siendo el diagnóstico más frecuente el síndrome postlaminectomía con 8 casos (35 %). La edad media era de 58 años, oscilando entre la más joven, 34 años, que era la que más dosis consumía, y la de más edad con 84 años. La DDD/día mayor es la de la paciente más joven con 34 veces la DDD, 2 con ocho veces la DDD, 2 con siete veces la DDD, dos con cinco veces la DDD, 1 con cuatro veces, 4 con tres veces y, por último, 11 pacientes que consumían el doble de la DDD. Todos los pacientes tomaban un opiáceo para el dolor irruptivo, la gran mayoría (17 pacientes) tomaban comprimidos de fentanilo oral transmucoso (Effentora® o Actiq®). La mayoría de los pacientes tomaban oxicodona (7) o fentanilo transdérmico (8), como opioide de acción retardada. Dos pacientes no tomaban ningún opioide de acción retardada. Se observó que once pacientes (47 %) tenían algún antecedente psiquiátrico, dos de ellos tuvieron algún intento de autolisis. Conclusiones: El uso inadecuado de opioides se da sobre todo en pacientes no oncológicos. Había una relación clara con patología psiquiátrica. Hay relaciones de uso inadecuado y abuso de opiáceos con los de acción rápida, sobre todo fentanilos, aunque el abuso de opioides es poco frecuente, con lo que hay que ser cautos en iniciar tratamiento en DCNO. Hay que reevaluar de manera periódica la eficacia de los opioides, considerando la derivación a la Unidad de Dolor cuando la dosis de morfina supere los 180 mg de morfina o equivalente (AU)

Introduction: The treatment of chronic noncancer pain (CNCP) with opioids is controversial because its effectiveness on the long-term outcomes has not been proven. The few trials focusing on dependence and addiction demonstrated increased mortality among CNCP patients receiving high doses of opioids. We therefore decided to analyze patients living in the northern area of the province of Cadiz who had exceeded the defined daily dose (DDD). The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. Materials and methods: The northern area of Cadiz has a population of 360,000 inhabitants. Patients who exceeded the DDD of opioid in December 2014 were identified. The clinical history of each of these patients was studied retrospectively. Results: Twenty-three patients were identified who at least needed to double the DDD of their opioids. Consequently, the incidence of patients exceeding the DDD in the area under consideration was 1 per 15,000 inhabitants. Four of these were cancer patients (17 %) while the others suffered from CNCP (83 %). CNCP in these patients predominantly was of the osteo-articular type of pain (65 %), with the failed back syndrome, occurring in 8 cases (35 %), representing the most frequent diagnosis. Patient ages ranged from 34 to 84 Y with a median of 58 Y. The youngest of these (34 Y) requiring the largest amounts of drugs. The daily consumption of this youngest patient corresponded to 34 times the DDD, two other patients took 8 times the DDD, 1 four times, 4 three times and, finally, 11 patients needed to double the DDD. Todos los pacientes tomaban un opiáceo para el dolor irruptivo, la gran mayoría (17 pacientes) tomaban comprimidos de fentanilo oral transmucoso, effentora o actiq. Most of the patients were taking opioids for breaktrough pain, the vast majority of these (17 patients) using transmucosal fentanyl citrate formulations, i.e. Effentora® or Actiq®. Most of the patients took oxycodone (7) or transdermal fentanyl (8), as delayed action opioid. Two patients were not taking opioids with delayed action. It was noted that 11 patients (47 %) had a psychiatric history, 2 of them had a suicide attempt. Conclusions: The inappropriate use of opioids occurs mainly in non-cancer patients. There was a clear relationship with psychiatric disorders. There are relations of misuse and abuse of fast-acting drugs, especially fentanyls. Although the abuse of opioids is rare, so we must be cautious about starting treatment CNCP. It shoulf be bourne in mind that in these patients the effectiveness of opioids needs to be reassessed periodically, considering referral to the pain unit when opioid requirements exceeding 180 mg of morphine or its equivalent (AU)

Modeling the Adsorption of Oxalate onto Montmorillonite.

In this work, a multiscale modeling of the interaction of oxalate with clay mineral surfaces from macroscale thermodynamic equilibria simulations to atomistic calculations is presented. Previous results from macroscopic adsorption data of oxalate on montmorillonite in 0.01 M KNO3 media at 25 °C within the pH range from 2.5 to 9 have been used to develop a surface complexation model. The experimental adsorption edge data were fitted using the triple-layer model (TLM) with the aid of the FITEQL 4.0 computer program. Surface complexation of oxalate is described by two reactions: >AlOH + Ox(2-) + 2H(+) = >AlOxH + H2O (log K = 14.39) and >AlOH + Ox(2-) + H(+) = >AlOx(-) + H2O (log K = 10.39). The monodentate complex >AlOxH dominated adsorption below pH 4, and the bidentate complex >AlOx(-) was predominant at higher pH values. Both of the proposed inner-sphere oxalate species are qualitatively consistent with previously published diffuse reflectance FTIR spectroscopic results for oxalate on montmorillonite edge surface (Chem. Geol. 2014, 363, 283-292). Atomistic computational studies have been performed to understand the interactions at the molecular level between adsorbates and mineral surface, showing the atomic structures and IR frequency shifts of the adsorption complexes of oxalate with the edge surface of a periodic montmorillonite model.

In situ observation of biotite (001) surface dissolution at pH 1 and 9.5 by advanced optical microscopy.

Laser confocal differential interference contrast microscopy (LCM-DIM) allows for the study of the reactivity of surface minerals with slow dissolution rates (e.g., phyllosilicates). With this technique, it is possible to carry out in situ inspection of the reacting surface in a broad range of pH, ionic strength and temperature providing useful information to help unravel the dissolution mechanisms of phyllosilicates. In this work, LCM-DIM was used to study the mechanisms controlling the biotite (001) surface dissolution at pH 1 (11 and 25 °C) and pH 9.5 (50 °C). Step edges are the preferential sites of dissolution and lead to step retreat, regardless of the solution pH. At pH 1, layer swelling and peeling takes place, whereas at pH 9.5 fibrous structures (streaks) form at the step edges. Confocal Raman spectroscopy characterization of the reacted surface could not confirm if the formation of a secondary phase was responsible for the presence of these structures.

Eficacia de la radiofrecuencia convencional de geniculados para el tratamiento del dolor en gonartrosis moderada-severa / Effectiveness of genicular nerve radiofrequency treatment in knee osteoarthritis chronic pain

Introducción: la artrosis de rodilla o gonartrosis es una de las patologías articulares más comunes y extendidas en la edad avanzada, que se caracteriza, entre otros, por ocasionar dolor, rigidez e incapacidad funcional en un gran número de casos dificultando las actividades de la vida diaria. Objetivo: nuestro objetivo consistió en evaluar la eficacia del tratamiento con radiofrecuencia convencional de nervios geniculados en pacientes con gonartrosis rebelde a medidas conservadoras, en relación al dolor y mejoría de la rigidez y mejorar la funcionalidad, así como registrar los efectos adversos de la técnica en la gonartrosis. Como objetivo secundario nos planteamos valorar la reducción en el consumo de fármacos antiálgicos, así como la satisfacción de los pacientes tras esta nueva posibilidad terapéutica. Material y métodos: estudio prospectivo no controlado a una serie de pacientes con dolor moderado a severo por artrosis de rodilla a los que se realizó radiofrecuencia convencional de nervios geniculados de la rodilla. La medición del dolor se realizó mediante escala visual analógica (EVA) basal, al mes, a los 3 y a los 6 meses, y para la evaluación de la función se aplicó el cuestionario de Ontario McMaster Universidades Western (WOMAC) a los 3 y 6 meses tras el tratamiento. La respuesta al tratamiento se definió como ≥ 50 % de disminución de la EVA del dolor. Así mismo se registró el grado de satisfacción de los pacientes con la técnica. Resultados: se incluyeron 16 pacientes remitidos a nuestra Unidad con el diagnóstico de gonartrosis con dolor de más 3 meses de evolución, una intensidad del dolor medida mediante la escala VAS ≥ 5 y escala radiológica de severidad de Kellgren- Lawrence 3-4, en los que habían fracasado tratamientos anteriores. Se encontraron diferencias estadísticamente significativas en el valor del EVA inicial 7 (6-8) y el valor al mes 3,5 (1-6), tres 3,3 (1-7) y seis meses 3,37 (1-8) (p = 0,009). El 75 % de los pacientes presentó una reducción del EVA ≥ 50 % en el primer mes, el 68,7 % a los 3 meses, y el 65 % a los 6 meses de tratamiento. Con respecto a la mejoría del dolor y capacidad funcional medida mediante la escala WOMAC, se obtuvo una media inicial de 65,8 (54-79), de 54,7 (41-67) a los tres meses y 50,3 (37-69) a los seis meses, siendo estas diferencias estadísticamente significativas. En ningún caso hubo un empeoramiento de la sintomatología de los pacientes. No se objetivaron complicaciones serias derivadas de la técnica. Conclusiones: en conclusión, la RF convencional parece reducir de manera significativa la intensidad del dolor en un periodo de 6 meses en más del 50 % de los pacientes, al igual que mejora la capacidad funcional en pacientes diagnosticados de artrosis de rodilla. Son necesarios estudios más amplios, comparativos y prospectivos para poder realizar la evaluación de la eficacia de esta técnica (AU)

Introduction: Knee osteoarthritis is a common joint disease in the elderly characterized by pain, stiffness and functional limitation, and daily life disability. Objective: The purpose of this study was to assess the outcome in terms of pain, functional recovery, and side effects during six month of radiofrequency treatment applied to the articular nerve branches (genicular nerves) in patients with chronic knee pain. As secondary outcome we investigated pharmacological therapy reduction and patient’s satisfaction after treatment. Material and methods: This prospective, uncontrolled study involved 16 elderly patients with severe knee osteoarthritis pain after genicular nerve radiofrequency treatment. Visual analogic scale (VAS) was measured at baseline (before treatment), at one, three and six months post-procedure. For measurement of functional limitation we used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before treatment, and three and six months after procedure. Treatment response was defined as at least 50 % of VAS reduction. We also registered patient’s satisfaction after treatment. Results: We included 16 patients with severe knee osteoarthritis pain lasting more than three months, VAS score higher than 5, severe osteoarthritis in Kellgren-Lawrence classification (3-4) and pain resistant to conventional care. We found significant differences in the mean VAS value before radiofrequency 7 (6-8) and after one 3,5 (1-6), three 3,3 (1-7) and six months 3,37 (1-8) after treatment. 75 % of patients had 50 % of VAS score reduction after one month, 68,75 % of patients after three months and 65 % of patients after six months (p = 0,009). Moreover, we also found significant differences in WOMAC score mean values before treatment 65,8 (54-79) and after three 54,7 (41-67) and six 50,3 (37-69) months after radiofrequency. No patient reported a post-procedure adverse event during de follow-up period. Conclusions: RF application to genicular nerves showed significant benefit in terms of pain reduction and functional improvement in a 6 month follow-up in patients with chronic knee osteoarthritis and thus may be an effective treatment in such cases. Further trials with larger sample size and longer follow-up are needed (AU)

Bloqueo axilar ecoguiado frente a bloqueo infraclavicular ecoguiado para la cirugía de miembro superior / Ultrasound-guided axillary block versus ultrasound-guided infraclavicular block for upper extremity surgery

Introducción. Con la incorporación de la ecografía en la práctica habitual de la anestesia regional, el bloqueo infraclavicular ha ido ganando popularidad. La mayoría de los abordajes de anestesia regional del miembro superior tienen una alta tasa de éxito, y las diferencias en la eficacia y en la calidad del bloqueo deberían favorecer la elección de una técnica frente a otra. Nuestro objetivo fue evaluar si el bloqueo infraclavicular del plexo braquial presentaba ventajas respecto al axilar en relación con los tiempos de instauración y efectividad clínica. Métodos. Estudio comparativo, prospectivo, aleatorizado entre el bloqueo infraclavicular ecoguiado y el bloqueo axilar ecoguiado en la cirugía de miembro superior. Se evaluó el tiempo anestésico total (definido como la suma del tiempo de realización del bloqueo y el tiempo de instauración). Se registró la tasa de éxito (anestesia quirúrgica), la duración de la analgesia, el dolor postoperatorio mediante escala visual analógica y la incidencia de complicaciones durante y tras la técnica (hasta 24 h después). Resultados. Se incluyeron 82 pacientes, que se dividieron en 2 grupos: bloqueo infraclavicular (BI) (n = 42) y bloqueo axilar (BA) (n = 40). No se observaron diferencias entre los 2 grupos en cuanto a tiempo de realización del bloqueo, tasa de éxito (90-95%) y dolor postoperatorio. Comparado con el abordaje infraclavicular, el grupo BA requirió un mayor tiempo de instauración, 10,2 min (DE ± 1,4) frente a 6,35 min (DE ± 2), siendo esta diferencia estadísticamente significativa (p < 0,05). Además, hubo una mayor duración de la analgesia en el grupo BI que en el grupo BA, 20 h (DE ± 1,36) frente a 13,70 h (DE ± 2,16), respectivamente. Las únicas complicaciones registradas fueron punciones vasculares, que no tuvieron incidencias. Conclusiones. El BI proporciona una eficacia similar, con un menor tiempo de instauración del bloqueo y una analgesia más duradera que el BA(AU)

Background. Most upper limb regional anaesthesia techniques are successful, and differences in efficacy should dictate the choice of technique. Methods. This prospective, randomised study compares ultrasound-guided infraclavicular (IB) and ultrasound-guided axillary brachial plexus blocks (AB) for upper limb surgery. Anaesthesia time (performance time and onset time) was the primary outcome measure. The success rate (surgical anaesthesia), analgesia duration, postoperative pain scores, and the incidence of complications over the following 24 h were recorded. Results. A total of 82 patients were included in the study, and received either IB (n = 42) or AB (n = 40). No differences were observed between the 2 groups in terms of total anaesthesia-related time, performance time, success rate (90-95%), or postoperative pain scores. Compared with the infraclavicular approach, ultrasound-guided AB group required a longer onset time, 10.2 min (SD ± 1.4), than IB group, 6.35 min (SD ± 2). IB was also associated with a longer analgesia duration than that of AB; 20 h (SD ± 1.36) versus 13.70 h (SD ± 2.16), respectively. The only complications we observed were uneventful vascular punctures. Conclusions. We can conclude that compared to ultrasound-guided AB, ultrasound-guided IB provides a similar efficacy, a shorter onset time and longer lasting analgesia(AU)

[Ultrasound-guided axillary block versus ultrasound-guided infraclavicular block for upper extremity surgery]. / Bloqueo axilar ecoguiado frente a bloqueo infraclavicular ecoguiado para la cirugía de miembro superior.

BACKGROUND: Most upper limb regional anaesthesia techniques are successful, and differences in efficacy should dictate the choice of technique. METHODS: This prospective, randomised study compares ultrasound-guided infraclavicular (IB) and ultrasound-guided axillary brachial plexus blocks (AB) for upper limb surgery. Anaesthesia time (performance time and onset time) was the primary outcome measure. The success rate (surgical anaesthesia), analgesia duration, postoperative pain scores, and the incidence of complications over the following 24h were recorded. RESULTS: A total of 82 patients were included in the study, and received either IB (n=42) or AB (n=40). No differences were observed between the 2 groups in terms of total anaesthesia-related time, performance time, success rate (90-95%), or postoperative pain scores. Compared with the infraclavicular approach, ultrasound-guided AB group required a longer onset time, 10.2min (SD±1.4), than IB group, 6.35min (SD±2). IB was also associated with a longer analgesia duration than that of AB; 20h (SD±1.36) versus 13.70h (SD±2.16), respectively. The only complications we observed were uneventful vascular punctures. CONCLUSIONS: We can conclude that compared to ultrasound-guided AB, ultrasound-guided IB provides a similar efficacy, a shorter onset time and longer lasting analgesia.

Gastrostomía percutánea endoscópica y posterior traqueostomía en un paciente con esclerosis lateral amiotrófica / No disponible

No disponible

Surface chemistry of K-montmorillonite: ionic strength, temperature dependence and dissolution kinetics.

The surface chemistry of K-montmorillonite was investigated by potentiometric titrations conducted at 25, 50 and 70 degrees C and at ionic strengths of 0.001, 0.01 and 0.1 M KNO(3). Proton adsorption decreases with electrolyte concentration at all pHs. The pH of zero net proton charge (PZNPC) decreases from 8.1 to 7.6 when the ionic strength increases from 0.001 to 0.1 M. Temperature has a very small effect on surface charge. A constant capacitance model that accounts for protonation/deprotonation of aluminol and silanol edge sites and basal plane H(+)/K(+) exchange is used to fit the experimental data. H(+) and OH(-) adsorption to specific surface sites appear to account for the pH-dependence of the K-montmorillonite dissolution.

Aplicación de la telemedicina a la Cirugía Mayor Ambulatoria / Application of telemedicine and major out-patient surgery

La Cirugía Mayor Ambulatoria es uno de los pilares donde se sustenta la eficacia de una Unidad de Cirugía. La Telemedicina utiliza al máximo las posibilidades que le ofrece la transmisión de imágenes y datos pero sobre todo aporta un elemento primordial en la continuidad asistencial: proximidad entre el paciente y el equipo de profesionales que se ocupan de su salud tanto en el ámbito hospitalario como de Atención Primaria. La Zona de Levante/Alto Almanzora cuenta con un equipo de Telemedicina conectando un Hospital de Huércal-Overa (Almería) con los diferentes Centros de Salud. Hemos aplicado dicha tecnología en la Cirugía Mayor Ambulatoria y una valoración de sus posibilidades basadas en su posible utilidad para cirujanos, médicos de familia y para los pacientes. Fueron sometidos 108 pacientes a una intervención de CMA: 74 hernias de la pared abdominal, 18 colelitiasis y 16 intervenciones proctológicas. A las 24 horas eran citados en la consulta de su médico de familia para realizar una teleconsulta con su cirujano. La calidad de la comunicación fue del paciente muy alto (97%), sin embargo, para el 77,7% de los médicos de familia este procedimiento interfiere en su trabajo diario frente al 15,3% del personal hospitalario implicado. La aplicación de la Telemedicina a la CMA aporta las siguientes ventajas: reduce las desigualdades en la población para beneficiarse de los programas de Cirugía Ambulatoria, acerca la asistencia especializada a la Medicina de Familia permitiéndole un contacto más cercano y participar en proyectos comunes, colabora en la formación continuada de los profesionales de los Centros de Salud e incrementa el grado de satisfacción y de confianza en la asistencia en régimen de cirugía ambulatoria (AU)

Major Out- patient Surgery is one of the pillars on which the efficiency of a Surgery Unit is based. As this article explains, Telemedicine brings an essential element in nursing continuity in these services: proximity between the patient and the team of professionals taking care of his health both in the hospital and in the Primary Healthcare Centre, collaborating in the on-going training of Health Centre professionals and increasing the level of satisfaction and confidence of the patient in the out-patient surgery system (AU)

Halobacillus alkaliphilus sp. nov., a halophilic bacterium isolated from a salt lake in Fuente de Piedra, southern Spain.

A Gram-positive, spore-forming, halophilic bacterial strain, FP5T, was isolated from a salt lake in southern Spain and subjected to a polyphasic taxonomic study. Strain FP5T was strictly aerobic. Cells were coccoidal, occurring singly or in clusters. The cell-wall peptidoglycan type of strain FP5T was A4 beta based on l-Orn-d-Asp. Strain FP5T was characterized chemotaxonomically by having MK-7 as the major menaquinone and anteiso-C15 : 0, anteiso-C17 : 0, iso-C15 : 0 and iso-C16 : 0 as the main fatty acids. The isolate grew optimally at 37 degrees C and in presence of 10 % NaCl; no growth was observed in the absence of NaCl. The DNA G+C content was 43.5 mol%. Phylogenetic analyses based on 16S rRNA gene sequences showed that strain FP5T falls within the evolutionary radiation of species of the genus Halobacillus. Levels of 16S rRNA gene sequence similarity between strain FP5T and the type strains of nine recognized Halobacillus species were in the range 97.0-99.0 %. Levels of DNA-DNA relatedness indicated that strain FP5T represents a genomic species that is distinct from recognized Halobacillus species. Strain FP5T could be differentiated from recognized Halobacillus species based on several phenotypic characteristics. On the basis of phenotypic, phylogenetic and genomic data, strain FP5T is considered to represent a novel species of the genus Halobacillus, for which the name Halobacillus alkaliphilus sp. nov. is proposed. The type strain is FP5T (=DSM 18525T =ATCC BAA-1361T).

Episodio de glaucoma agudo de ángulo cerrado tras cirugía ginecológica con anestesia general / No disponible

No disponible